| NPI | 1699218735 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 106H00000X Marriage & Family Therapist (Licence: CA 110977) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: CA IMF95867) |
| Enumeration Date | 2016-11-21 |
| Last Update Date | 2023-03-08 |